Monday, July 23, 2012

The Colorado Tragedy: What Families Are Asking

Along with so many other Americans, NAMI members have been saddened by the tragedy in Aurora, Colo. in which 12 people were slain and 58 wounded in a theater at the premiere of a Batman movie.

NAMI does not speculate about mental illness or other factors that may be involved in such tragedies—or for that matter other kinds of news events. No one should diagnose through the news media.

Despite many public perceptions, we do know that generally the likelihood of violence from people with mental illness is low. In fact, the U.S. Surgeon General has reported that “the overall contribution of mental disorders to the total level of violence in society is exceptionally small.” There are many reasons why violence occurs in our society, many of which have nothing or little to do with mental illness.

On the other hand, violence sometimes occurs. In some cases, it is because something has gone wrong with the mental health care system. At this time, that does not seem to be the case.

Recognizing that there is a problem is always the first step. Right now, public inquiry is focused on whether or not the behavior of the person responsible for the tragedy ever caused anyone or any institution to encourage or require him to be evaluated

The Surgeon General has acknowledged that the risk of violence among individuals with mental illness increases to some degree in the case of substance abuse or psychosis, a symptom which typically involves a “break with reality” through paranoia, hallucinations or delusions. Social withdrawal may precede such breaks. Early warning signs of psychosis, particularly in the year leading up to the break, may include:

Worrisome drop in academic or job performance

New trouble thinking clearly or concentrating

Suspiciousness or uneasiness with others

Decline in self-care or personal hygiene

Spending a lot more time alone than usual

Increased sensitivity to sights or sounds

Mistaking noises for voices

Unusual or overly intense new ideas

Strange new feelings or having no feelings at all

Young adults in their 20s are the most common age group to experience the first onset of psychosis. This is a stage of life that usually challenges young people to develop more independence, establish an identity, create intimate relationships and move away from home. Immediate family members, who usually are most aware of changes in behavior of a loved one, play a less central role at this time, particularly if a person has moved to another city or state, such as to attend college or graduate school.

Psychosis is treatable. Many people recover from a first episode of psychosis and never experience another one. The first step, however, is always recognizing onset of the illness and getting treatment.

Again, one cannot diagnose based on media reports. Risks of violence among people with mental illness are low overall. It is important not to perpetuate stigmatizing stereotypes. However, NAMI has been asked by the news media and many concerned families over the last few days about warning signs and what to do.

Regardless of whether or not violence is a concern and regardless of what the case may turn out to be in the Aurora tragedy, the first step is to recognize warning signs of illness and to reach out to a person who may be in trouble. Help them get help.

For more information about mental illness, treatment and recovery, please browse this website or call the NAMI HelpLine at (800) 950-NAMI (6264).

90 comments:

"On the other hand, violence sometimes occurs. In some cases, it is because something has gone wrong with the mental health care system. At this time, that does not seem to be the case." I disagree. This case strongly points to something wrong with our mental health system -- obtaining help for a mental disorder is much, much, much more difficult than obtaining a weapon. "Help them get help" is so easy to write but almost impossible to put into practice. As a parent, I spent 6 months trying to get help for my son. It was a nightmare. It is misleading for NAMI to say that often there is only one episode of psychosis. When in actually, major mental disorders are life long relapsing/remitting illnesses that require the work of many people to keep a person in recovery mode. NAMI should advocate for those whose disorder includes the propensity for for violence when the person is replasping -- those are the ones who need us most, but are the ones who get least attention on the NAMI website. As a society, we can do better than this and NAMI should set the example. Of course, most most people who have mental disorders aren't violent -- but what about the ones that are?? No one gets to chose their symptoms. Tucson and now Aurora; NAMI's statement to the media is much the same. And it comes up so short. We have got to do better -- lead us, NAMI.

I believe the parents of this young man were aware of changes in their child...even from a distance. That being said, there is little they could have done to prevent this horrible tragedy from happening. I, too, see a decline in the mental health system of care. Parents and other family members are now charged with recognizing symptoms and getting their loved one into treatment. The role family members have been forced to assume is difficult and at times impossible. Until health professionals, insurance providers, and others, recognize mental illness as a legitimate and treatable illness, I fear litte will change.

Thank you for a thoughtful article and not addressing the news media but our families. I am sick of newspapers and TV that print only short bites. Thank you for the link on How to Get Treatment. The MH system is horrible, but the links tell what to do and how to get through it. NAMI also fights to change it. Not many others do. You make enemies, but do not stop.

The thing that is most disturbing to me about the colorado case is that everyone has an opinion about the cause and NOBODY in the media is talking about mental illness (and our country's lack of ability to support family members in getting care for their mentally ill loved one.) The reality is that violence can and does happen during untreated psychotic episodes (depending on the nature of the delusion.) I am very sad that we have such a fantastic opportunity RIGHT NOW to start a national dialogue about the importance of supporting family members seeking treatment for their mentally ill loved ones--and we are blowing it.

I am a parent of a fourteen year old boy who suffers from mental illness. While my son has not shown violence toward others at this point, his behaviors can be volatile and my greatest fear is that his face will be on the news one day just as the young man who we are watching on the news after committing the horrible and senseless crimes in Colorado.

My heart aches for the victims and their families but my heart also breaks for the parents and family of the killer. I realize we don't know what happened or what caused this man to be so calculated in this dreadful crime, but you are right...this horrific event has definitely left me with burning questions and a sick feeling in my gut.

My beloved son has suffered from mental illness almost his entire life. I have done everything I know to do up to this point to provide the help, structure and treatment he requires. I am now at a crossroads as I find myself in the difficult quandary of finding help for my son. I live in California. My son was in residential treatment for two and a half years and he discharged 11 months ago. As I have tried to find outpatient services to meet his challenging needs, I have run into road block after road block. It is most discouraging.

The help that my insurance provides is minimal and most of the people will not see my son because of the severity of his disorders. Medi-Cal, provided through the state provides all of the outpatient services that my son would benefit from. However, I am a hard working, tax-paying citizen and I make too much money to qualify for their programs. Keep in mind, I do not make a six figure salary. I am very middle class but I make enough to keep me from being eligible for mental health services.

With that said, I am certain I am not the only person facing these challenges. I would do almost anything to provide help for my son but there is no where to turn. When I see a situation like the one in Aurora, I wonder to myself how we can make changes to the current situation so that the mentally ill and their families can receive the treatment and services they need on the front end to avoid becoming the next family portrayed as evil villains on the news. The system has to change!

I am currently on vacation and I found a book on my Kindle yesterday called "My Brother Ron" that seems to address some of my frustrations. I have only just begun to read it, but I hope it might shed some light. In addition, when I return home next week, I intend to begin researching ways to get involved so that perhaps I can be a catalyst for positive change. If anyone has suggestions or is interested in getting involved to help the mentally I'll and their families, please let me know!

Continued prayers for everyone affected in Colorado and for every person who suffers from mental illness and their loved ones who would do anything to help.

I believe Mr. Fitzpatrick's comments are appropriate for what is known at this time. One of NAMI's main roles is to educate about mental illness. He clearly achieves that. I also agree that diagnosing through media reports is inappropriate. Yet my heart yearns for more. Why?

How many parents know the bewilderment and pain of getting that phone call from their child's university that something is terribly wrong? Your son/daughter, who is a top notch academic achiever, is behaving very strangely and needs help.

How many of us have experienced our first major episode when our stress levels were "off-the-charts?" Finals, SATs, job loss, death of a loved one, PHD PRELIMS...

How many of us feel like "we know?" When this young man's brain should have reached maturity at 24 and his frontal lobe executive function blossomed to complement and regulate overall brain function, something went dramatically wrong. And, "we know" because recent brain science tells us, that his chemistry was probably awry long before this tragic and senseless behavioral manifestation.

How many of us know our own descent into darkness, which began when the instrument of our greatest achievements, and our most intimate friend, OUR BRAIN, became our ultimate betrayer? Our mental illness captured us, buried who we really are, and drove our behavior. Ensnaring our family, loved ones, and our world into our own private hell.

My HEART aches -- for the victims: the dead, the wounded, their families, those who were there... for this young man and his family.

Nothing excuses what happened nor mitigates the unfolding of informed justice. We are all responsible for the behaviors that manifest from our own private hell.

I agree with every word of the three previous comments. NAMI's Executive Director: please draft your next statements to the media to include what specific steps NAMI is going to take to help families help potentially violently mentally ill people get the treatment they need before they become violent.

I agree with prior comment. i have a bipolar son (30 yrs. old). i always thought something was "off" although he excelled in academics and sports. then around 19-20 he became psychotic speaking fast and extremely agitated. he was diagnosed with bi-polar disorder. now even on his meds he gets very angry and agitated daily. i love him and i know he will always live with me. my point is that some mental illnesses come out around the 20's. i imagine his parents knew something was wrong but were not informed about what to do. so i feel deep sadness for his parents. they also are victims. sad

My problem is, every time there is a mass shooting or the like it is immediately attributed to mental illness. In fact, I always try to guess how long it will be before the "talking heads" start diagnosing the shooter without ever talking to him--right now, go to CNN and see all the diagnoses there are from various mental health professionals based on the arraignment pictures/video. I think it's irresponsible to do this on such a small piece of info. As a CNN contributor said yesterday, there is evil in the world. I don't think anyone ever said Ted Bundy or John Wayne Gacy or Henry Lee Lucas had a mental illness, and they were famous serial killers who murdered many people over many years unlike the spree killings like Colorado or Tucson or Virginia Tech. If the Colorado murderer turns out to have a mental illness, such as some sort of psychotic break like that to which NAMI refers, I will not be totally surprised, BUT, as a successful professional who has a severe mental illness I do not appreciate having people wonder about me. Most of us are not violent, and most violent crime is not committed by those with mental illness--it is committed by CRIMINALS. Like robbers and burglars and drug dealers and gang members and the like. Check the murder statistics sometime and see who is doing the killing. It is not those with severe mental illness.

The comment, "This case strongly points to something wrong with our mental health system -- obtaining help for a mental disorder is much, much, much more difficult than obtaining a weapon" is so true! When is the press going to focus on the "real story": help for those who are crying out for help? Why do people have to be placed in a position where they are ready to commit suicide or violently hurt others before they get the treatment that they need. Sadly, after the victims are buried (and my heart goes out to their families), the press will consider the story "old" and again the real story will be buried too until another violent episode (though rare) occurs. NAMI, this was a "safe" press release. As an advocate let's be more aggressive in having the Press become an advocate with us for Mental Health Reform in America! Sadly, the possibility of violence with mental health is never an "old" story; let's keep it fresh, be aggressive, and put pressure on "credible" news reporting by the Press to bring improvement and positive change in our society!

As the parent of a son who had his first psychotic break 5 months ago, my heart breaks for his parents, the victims, the victims families and for him. Nothing could have prepared my husband and me for what happenned to our son. Although he was acting strange a few months prior to his break, we knew very little about mental illness. He was never violent but is still delusional and we take it one day at a time. God bless everyone who is suffering.

All Mr. Fitzpatrick said is that most people with mental illnesses are not violent and that most violent people do not have mental illnesses. No protection is absolute, but rules that apply to everyone could have made this tragedy less likely: make it harder to get assault rifles and ammunition whether diagnosed or not. I share the anguish of frustrated parents, but the problems of mental health systems are not part of this story.

I can appreciate how hard it must be very hard for NAMI to address that psychosis might have played a hand in this tragedy (which is a definite possibility, but only that at this point).

On one hand -- there is no doubt that the untreated symptoms of the most severe illnesses are often at least "a" cause of such horrific events.

On the other hand -- the extraordinary press that that creates is an unfair tar on the much very larger percentage of people with such illnesses who carry the burden of their symptoms but would never harm someone else despite them.

I totally agree with the previous comments, they are all true. I thank God daily for bringing us through each and every day. My son came home from school different than when he left that day and I'm sure it started before that day but that day all of our lives changed! The crisis line was great but it's like someone needing surgery because they have internal injuries and going to a hospital and they are given blood but their injury is not repaired, but they are sent home until they require more blood! It doesn't make sense! Then no one gives you information, it's like pulling teeth. Then we don't even want to talk about school? Another nightmare!Where can you go to get help in Texas? Help with getting my 17 to graduate, with disability papers, medical bills and insurance to pay them? Help when your at work not leaving your child alone at home?

I totally agree with you...We have a fantastic TEACHING MOMENT for the whole nation to be educated about the sorry state of Mental Health Care SysTem in our country. And organizations like NAMI whose opinion is sought for gives an unlikely explanation...saying Psychosis is NOT recurrent...and omitting how difficult it is to get help for somebody with a Mental Illness due to expensive medications, lack of insurances, rejection of Medi-Care and Medi-AID by most of psychiatrists...scarcity of Public Clinics and Psychiatric Units or Psychiatric Hospitals..Not to mention these unfortunate patients' denying their own condition for justifiable fear of being stigmatized or criminalized.NAMI Please use this moment and say what the PUblic needs to hear in order to CHANGE the current situation. Otherwise, tragedies like the one in Colorado will be repeated.

"The Surgeon General has acknowledged that the risk of violence among individuals with mental illness increases to some degree in the case of substance abuse or psychosis, a symptom which typically involves a 'break with reality' through paranoia, hallucinations or delusions." This may be true, but I just wanted everyone to know that almost 14 years ago, I had a psychotic episode, and I was never in the least bit violent. I also have never had another psychotic break after my first and only one-- I credit that to strictly following a medication regimen.

As the parent of a schizophrenic son who had his first psychotic break when he was twenty, I'm sitting on pins and needles waiting for some media know-it-all jerk to scream out "Schizophrenia." It's the media who give schizophrenics a bad name. I know quite a few who are sweet, wonderful people, better people than so-called "normal" folk. It's stigma when that term is the first tossed out by media& the public in the minutes, days, weeks following such incidents. Why can't the Colorado shooter simply be an evil young man? Evil exists and being evil doesn't mean the person is mentally ill. The media needs to stop diagnosing and focus on delivering the news in an unbiased fashion. Why doesn't NAMI say that? Someone from NAMI should've been on CNN or local news programs demanding that conclusions not be jumped to and that doing so stigmatizes those who are truly mentally ill. Stop being so politically correct NAMI!!

I believe that many people, the media included, would prefer that James Holmes be responsible and thus "evil." Somehow they don't seem to want to understand that a person can behave bizarrely due to a malfunction in brain chemistry. They reject that as false or not possible. They only understand behavior as being the function of a person's will. So if you behave a certain way, you knew what you were doing.

I am the parent of a son who was diagnosed with bipolar/schizo-affective disorder.He has a college degree that he cannot use. He is on disability. I am saddened by the events of last week in Auroro. My son is not violent when he is manic, but he is extremely difficult to deal with. We have been living with this illness for seven years. Every episode was getting worse and worse. I can't tell you about all the roadblocks we had to go through to get him care. His last episode we had to travel for 1/2 hour to get paperwork to have him committed. Then we were harassed about it. He was hospitalized for 2 weeks and then they wanted to release him We told them he was not ready. He was released and we had six more week of pain. He was committed again and finally was getting better. We went through five doctors before we found a good one. My son is doing better now on his meds, but we are constantly watching him. We as a country need to have more help for people with mental disorders and their families. It is such a disgrace. I could really go on and on. We had to find every bit of information on our own. Something has to be done!!!

For parents with mentally ill sons and daughters, the NAMI Family-to-Family program was a lifesaver for me. If you can find one in your area, make every attempt to attend EVERY session (It's either 8 or 10 - can't remember) and there was no charge.

In the instance of my son, it was deployment to Iraq that unraveled his life. He had already served 4 years in the USMC in an anti-terrorism batallion and received numerous promotions and awards. His enlistment up, he came home to begin school but within 5 months, he was recalled for deployment.

He was an excellent leader and during their training leading up to the deployment was offered the opportunity to attend highly specialized sniper training. After several weeks of training, he opted to go back to lead his unit once again. When they arrived in Iraq he had an abundance of responsibilities and never backed down. But after a few months, after some horrific incidents took place, he was starting to lose it. He'd only sleep 2 hours per day - if that. He asked for help but was told there weren't enough guys there to even let him "chill" for a couple days. He snapped and his 'crime' was sending a 9 mm pistol and booze to his grandfather - he doesn't remember doing. He was becoming psychotic, suicidal and his horrific nightmares were scaring the other Marines. He was 'Medivaced' back to San Diego.

Sadly, instead of checking him for mental illness, he was sent to the brig. After a suicide attempt within the first few weeks, he was sent to Balboa Naval Hosp. where he was diagnosed with PTSD. They kept him there for a few weeks and sent him back to Camp Pendleton brig and told to come to weekly appts. for treatment. The command did NOTHING to get him to the appts. so he ended up with another suicide attempt - yet more serious than previously. Back to Balboa and this time diagnosed with Bi-polar and PTSD. In the meantime, my parents had hired a civilian atty. to assist with his case and treatment since we had NO doubts of his condition - completely out of character for this highly functioning young man before deployment. We fought for everything to help him but the lack of care had already destroyed his spirit. An expert psychiatrist evaluated him on several occasions and confirmed the diagnosis of bi-polar and PTSD was a result of deployment. It was during this time when I got involved in NAMI. In the long run he took a plea to get out of the military to get better treatment. They took him straight to the airport without so much as a couple days worth of the medications they'd been using for treatment.

Obviously, it went from bad to worse and our battles to get him the proper care and discharge has been ongoing for SEVEN years. He has received some care from the VA but is now under the [outpatient] care of our local mental health center. He's highly intelligent but disabled. He cannot focus for any length of time and still has horrific nightmares. Most discouraging is the fact the mental health center doesn't have anyone who specializes in treatment for vets so he gets frustrated. He only receives a small income from SSDI (less than $1000 per month) and I, as his mom, do what I can to help him out. It's difficult as a single mom and my salary isn't the greatest. We don't have a car or TV but our family bond is what keeps us going (I have another son ten years younger).

I'll continue to fight for him if it takes me all the way to the White House! He has been through 'he11' and the govt. has refused to take responsibility for his lack of proper treatment at the first sign of his illness while in Iraq. He was treated as a prisoner because of a mental illness! BUT, and here's the worse thing: This is happening EVERYDAY to our troops!

So sorry to ramble on but there is so much more to this story (he was featured in GQ Magazine and our local newspaper over the years) but it's not over! As I say to him, NEVER GIVE UP!

I too suffer from a thought disorder that may give you thoughts that are not of you but its YOUR choice wether to act on them or not . this crap about drugs being a cause is bougus .they are so quick to say that ....I here it all the time .....all the drs do is pass the buck ..the health care system sucks I fight with pain emotional everyday and the truth is the ones that are supposed to help dont..they say drugs....or your being paranoid ..whatever you try fighting mental illness of that nature everyday...you will be quick to see no one really cares and that kills me...God is the only one i can count on ..the drs suck..I dont know what happend in CO and i do feel bad about what happend but dangit the healthcare system sucks BAD with these kinda issues . all they care about is if your homicidal or suicidal SADLY thats the only way you can get imediate help..im tired of being so paranoid about this ....not fair to those that fight this everyday...and ontop of that as soon as you leave the hospital your left with a illusion of hope ...fewww

To the parents who have commented above, my heart hurts for you. The few inpatient facilities that are available have a goal of discharging patients faster that the drive-thru service at McDonald's. It's a disgrace.To the folks who have their disorder under control and are able to participate fully in life: my heart hurts when I read that you are shunning those people whose disorders aren't being diagnosed/treated because YOU don't want the stigma? The best way to end the stigma is to advocate for early, appropriate, accessable treatment for EVERYONE instead of chastising those whose psychosis put themselves and others at risk of death. My schizophrenic mom-in-law was gentle & kind -- a lovely woman, even during a relapse. My schizophrenic brother was talented & funny & giving -- but was one of the 50% with anosognosia and was non-compliant, spent time in jail & violently ended his own life. I loved them both. Same diagnosis, but a very different outcomes. Both of them were good people and neither of them deserved the stigma -- especially from the very people who are also affected!

Some people have one psychotic break and never another. Others have multiple breaks, and some never return to their pre-psychosis life. There’s no single pattern. Most people with mental illness are not violent, and most violence is not waged by people with diagnosable mental illness. But it’s ludicrous to suggest that someone who kills a group of movie-goers is mentally healthy (unless one believes in “evil”, which I do not). James Holmes aside, it is easier to procure weapons than to procure decent treatment for those with severe persistent mental illness. Private programs are too expensive for most us (the 99%); public programs are under-funded and under-staffed. Over and over, my stepson was bounced out of psychiatric wards when he obviously wasn’t yet stable, his stays limited by insurance protocols and overcrowding on wards. He was refused admission to some programs because he was too ill, but refused admission to others because he wasn’t ill enough. Ultimately the agency that really sat up and paid attention was, of course, the police. Now my stepson is in jail awaiting trial, and the prospects are gloomy because our legal system is as uninformed about mental illness as is the press and the public.

We need better education about mental illness; more funding for more and better mental health services; more support for families who have to wade through the quagmire of services; and we need more research into causes of MI and effective treatments, including possible medications that don’t have lousy side effects. As some above suggested, we should seize this opportunity to broaden the national dialog about mental illness.

It will be interesting to find out if in fact this young man had just been started on an antidepressant and it triggered mania. This happened to my son and it was hell to get him into treatment because he was an adult who refused to admit himself in the hospital after the mania kicked in.Never did and he went on psychotic for 9 months then commited 2 acts of violence which landed him in jail. I tried to get help through out all of this mess. The psyciatrist refused to help, call 911 was her reply. The police thought is was a joke, the local hospital gave him Geodon and releases him after four hours. He returned 4 times to ER to be released.It wasnt until he threateded to stab 2 people did he get put into the hospital. Therefore I feel psyciatrists, the mental health system and law enforcement should be monitering and procative right at the time someone is written a new med and they have manic side effects. This is the point of no return for some. Many lives are affected because an antidepressant triggers mania.This problem needs to be dealt with. Source:My adult son and how Abilify triggred mania, and how a psyciatrist and local hospital ER's inept response to mania,and uneducated law enforcement does harm. That is how we have these tragdies.

I appreciate this article, yet I have an expectation that NAMI would be a visible and audible voice in the midst of this national discussion. It appears as an opportunity to educate the general public and highlight the limitations of the existing Mental Health system, the negative impacts and perhaps unintended consequences of HIPPA that often encumbers families in their efforts to help their loved ones, who may well become ill after 18 yrs of age.

In the midst of this American tragedy the topic that is often taboo needs to be unveiled and demystified. The tragedy is not only in the devastation wrought by one individual against these innocent victims, yet also, as an indictment of the current state of the mental health system in this country.

I will await to hear information that will eventually be learned, however the young mans age alone is one indicator of when serious mental illness strikes. Other indicators have been reported by the media, however there is little public dialogue coming from NAMI to help balance the public discourse.

Dismantling the mental health system of yesteryear has left a vacuum which has yet resulted in workable solutions for treating illness as acute as cancer. One result of this broken system is unmonitored, worsening illness, and often self medication via substance abuse by those left to fend for themselves.

Mainstream Americans have little awareness of this impact until it strikes close to home. When viewing from a distance, or after an act so horrific that it defies understanding, the easy way out for media is to direct the dialogue toward gun control and how media coverage addresses the "suspect". These are valid and understandable reactions, yet they offer no long term remedy to the increasing occurrences of these types of tragedies. Without NAMI entering the dialogue in a very public fashion the educational benefit is lost.

There are many parents and families in this country grieving deeply the loss of these innocent men, women and children, the grief of their families and of lives forever changed. Some of these are NAMI members, some are not and could benefit from learning about NAMI. Remaining relatively quiet seems inexplicable to me.

I suggest a dialogue that could prove more beneficial would include addressing mental health issues, treatments and interventions.

NAMI needs to be a presence in the national dialogue. I don't understand the nearly deafening silence.

Additionally, in our media driven lives, a reevaluation of the impact, consequences and responsibilities of our cultural acceptance of unfettered violence as "entertainment". Days prior to this tragedy, flipping channels left me with this thought, "Thank God for Antiques Road Show".

Schizophrenia is a thought disorder, a true medical condition. Some of you know. You have a relative who beleived they were Jesus or God? I did, two of them and both thought spirits were taliking to them. One thought messages on the side of truck were directed towards him and the TV talked to him.

My question is why so much attention on AIDS, cancer and the like and very little on schizophrenia which destroys young people, their families and affects and is genetic not preventable like AIDS, cancer ,etc???

This is a really fair and informative statement coming from NAMI. Thank you! Has this been quoted anywhere in the mainstream media? My only suggestion is that you share some statistics in about violence.

I have bipolar disorder. In recent years I've been open about it. When I read what people write about mental illness and the mentally ill in the comments of news articles about the killings in Aurora, I wish I could crawl back into the bipolar closet. I don't want my neighbors and co-workers to be afraid of me because of my mental illness.

Sadly, I know at least some aspects of what James Holmes' parents are feeling…the sadness, societal accusations, the stigma, the relentless misunderstandings of the underlying disease of mental illness. If James had had a disease like cancer, he and his family would have sympathy…. but mental illness, especially involving delusions/ hallucinations, is met by harsh accusatory judgement. "What did they do wrong?" And yet, it really all comes down to a simple consideration: there but for the grace of God, go I.

A neural misfiring, perhaps an imbalance of dopamine, a flawed chemical response to stress…. any one of us, there but for the grace of God.

And to those who think this happens only to others, think again. I’ve seen previously “normal” people in psychiatric care because of an accidental bump on the head –- or TBI from a car accident on the way home from work, or from the grocery store --an unexpected event that rearranged life. Hallucinations, anger, isolation. It can happen to any of us, at any time. And then there are people, perhaps James Holmes is one of them, who came into this world with a brain chemistry that is more fragile, more susceptible…. people with Aspergers, for example…. who are persecuted for their inability to respond to social cues. I believe the people at Salk Institute, former teaching assistants, were quoted as saying they remember Holmes as "socially inept" "stubborn" "a dolt" ... harsh words against a smart, young 18 yr old., and a harsh reality to endure and negotiate. Sometimes keen intelligence comes with precarious developmental vulnerabilities.

As for James Holmes, perhaps stress was the tipping point of a fragile brain. In any case, his reality was distorted----and when you don’t have a grasp of what is real, any darkness is possible. I feel deeply for the victims and their families, for the parents of James Holmes, and for James Holmes himself. I can’t imagine the gut wrenching realizations he faces now, as his brain cycles in moments of lucidity, when the neurons connect, when brain receptors rebalance. His disease has taken both his life, and the lives of others. This is a tragedy that deserves our compassion, and our understanding. There but for the grace of God.

I thought NAMI had an appropriate response. As a parent of a daughter that has schizophrenia, I can tell you it has been a rough road. She had taken off to California to see her sister w/o our knowledge and problems emerged in reports from my other daughter of odd behavior. I told my daughter to have her go to a hospital there. They admitted her and then released her! Several people told me in the system that it was like a revolving door, and people never really get the help they need. She ended up in Vegas. She was rapped twice out there, and ended up in a store distraught and hungry. Someone called an ambulance. She was then taken to a Vegas Mental Health facility. She was very well taken care of there and transferred home! My other daughter helped her sister through the checkpoints at the airport, on the way home to us. Her recovery was all done with the help of many…including someone in NAMI, that I called prior to her arrival. Then after group home treatment, my daughter w/ schizophrenia was then put in housing that they said was nice. The cops later told me different. My daughter was vulnerable and trusting there, and was raped by 2 men who put choke marks on her neck and body then led her to an ATM and took what little money she had out of her savings. The system puts vulnerable adults in low-income housing. This is inappropriate for them. My daughter is higher functioning. My daughter finally is in housing that we found for her, and is suitable for her in a small town, and nice apartment. She cannot afford a 1 bedroom, but is happy to be independent in a studio. Food is always an issue, as it is never enough for her to survive. She has no transportation to a job that is too far away from her home, because of the bus schedule in her small town. NAMI is working on getting transportation so people can have jobs in areas like my daughter. I worry about the time when she has no advocate….as I have had to advocate for her many time’s to get the necessities she needs I.E. food / money / housing ect. They just recently tried to short her money to live. I had to call NAMI again, and they helped. I don’t know where she would be w/o them

Getting help for someone who does not think they have a problem is harder then you think. You contact their DR you contact the police, you contact eveytone possible and no one will help. Then your loved one ends up in jail. NAMI needs to get more involved in the Criminal Justice System! Mental Health and the Criminal Justice System seem to be hand in hand now.

NAMI needs to get involved with the Criminal Justice System. Mental Illness and the Criminal Justice system seem to be side by side now. We try to get our loved ones help by contacting their Dr and the police but no one will help. NAMI GET INVOLVED with the CRIMINAL JUSTICE SYSTEM. There are plenty of families going through crisis.

I also agree with you. My son is 32 and bipolar 1 with no insurance, no money and most oc the find goes without medication. Talk about trying to geg him help, I know exactly what you mean. When my son is manic I get concerned with what he may do if angered. WE NEED MENTAL HEALTH CARE for our loved ones. What occurred in Colorado and Arizonia is going to continue to happen if the people who suffer from mental illness can not get the treatment they deserve!!!

Only have read half the comments not sure if the two points I will express have already been so. First is I do wish that there was more news and awareness for the general public and NOT just for those of us that live the life one way or another. It is frustrating that those that have a higher level of communication tend to dance lightly as to not to jar or bring the wrong kind of attention. Education has to be forefront for the general public as much as possible and then some.Second, the descriptors that were used to describe behavior that should be of concern are often, EVERYDAY behaviors of my loved one that is NOT, I repeat Is NOT a threat.So now there are these words, alerting the general, uneducated public that is in fear of those that look a little different. I say NO THANK YOU to the explanation.I fear for my loved one that is away at school. That he should be radically misjudged and have actions that are negative onto him out of fear and misunderstanding.Sincerely,A past NAMI president, NAMI facilitator, and family member.

I am really saddened by the recent tragedy of the Aurora shooting and I have had times when I just cry out of the blue.I have however lately donated $25 on my credit card and $20 from my checking account to help the victims and their families since some of the victims don't have health insurance.I was so taken in my Caleb Medley whose wife just had a new baby boy Hugo.Caleb Medley,comedian,who was shot in the eye,and is in a coma,I donated $20 especially for his cause.If you find it in your heart even $5 or whatever you can afford could help these victims and I can say I felt a lot better since I donated money to help these individuals out.Community First dot Org and We Pay dot com. God Bless You, Michael Lee NAMI Member

The core issue at hand is directly related to stigma and societies inability to accept individuals with mental illness as being human.

When the onset of symptoms first occur most people are to embarrassed to discuss their symptoms. Over time the silence evolves into full-blown, untreated, mental illness.

The error lies in societies negative view on mental health combined with our inability to treat mental illness as an actual medical condition.

As a result of untreated mental illness, on rare occassion, people will sometimes commit acts of violence. This violence results in furthering the stigma and prejudice that exists against mental illness.

The other side of stigma lies prejudice. You cannot convince someone who discriminates against mental illness that they are prejudicial as they believe that their view is appropriate.

We are in a vicous cycle that cannot and will not be broken. I use to believe we actually had a chance to make a change. At every instance in which I believe a change can be made, I am forever reminded that it is impossible, as a result of violence in the news.

Please look into the WRAP program, it is a tool for those want to manage their disorder. Imfo is online just Google WRAP AND Ellen Copeland. Awareness is not enough people need tools they can use to manage the days ahead. It is the best free investment you will make if you line with a mental condition.

I just want to say to all of you, your comments are brilliant and I hope and pray NAMI steps up to the call you have put out there. I am an LCSW and I have seen many clients with untreated Bipolar become violent. As a profeesional in County mental health, our clients have to wait 2 months before they see the psychiatrist. It's rediculous. If I believe the person is high risk I will do what I can do to lower the risk, i.e, have them evaluated by the crisis team, talk to them about their options to stay safe, etc. But the majority of mentally ill ....wait.

I wonder why there has been so little discussion of the benefits of minocycline as shown in the recent headline case from Japan?

If in fact just one case has shown that mental illness can be cured in some cases by reducing brain inflammation, I'd think it would warrant a huge amount of attention from the medical community and funding on part with the defense department.

I think NAMI did a great job of "nipping it in the butt" we all know that once psychosis is mentioned in related to a violent situation things tend to get out of control in the media and the stigma against mental illness comes out.... very informative and hope providing article!

I am also disappointed with the NAMI statement about violence. I totally agree with the Treatment Advocacy Center and the difficulty with getting treatment. I feel lucky because I was able to implement AOT (Kendra's Law) however, I could been a different story. I was lucky that my son didn't do anything to cause him or anyone else harm. Psychosis can be dangerous and violent. I saw my mellow, sweet son get extremely upset and angry. I was scared of him many times throughout the first 4 years of his illness. I needed help sooner and it was impossible to get the help we needed. I think that this statement from Fitzpatrick is sad. Now is the time for change....we need to make our laws easier to access help in hospitals. We need more hospital beds too. Of course this colorado shooter was mentally ill. Didn't you see the joker hair? His look in the courthouse? His failing grades?? Why isn't NAMI doing more. Please read the Treatment Advocacy's stand on this matter. Thanks.

Im tired of NAMI taking a "passive" role and aligning themselves with the beaurocrats and funding sources-you use to help families...speak up! UNTREATED mental illness, esp those patients who are exhibiting serious symptoms such as delusional thinking and hallucinations-NEED mandatory medical evaluations! the CONTENT of their delusions need to be examined and monitored-for their safety and the communities! STOP saying those with mental illness are "not dangerous" when we deliberately and ON PURPOSE provide no intervention until a dangerous act occurs to self or others. Our JAILS are filled NATIONALLY 20-25% with the untreated mentally ill-so you will never convince society those with MI diagnosis are not dangerous! unless you take a strong stance to help those who are unable to adhere to their medication regime without supervision (remember the sickest patient also has a cognition impairment-its NOT DENIAL!)and help those who lack the cognitive understanding for their need for treatment>>>they will NEVER SEEK voluntary care in the "recovery and mental wellness" philosophy you have aligned yourselves with!!

Reading these stories solidifies the experiences felt in my own family. My brother has 3 sons - all have a form of severe mental illness. One committed suicide at the age of 25, one 32 has spent countless hours on the streets and in jail while schizophrenic, and one has attempted suicide several times and lives every moment of his life in a fragile state. AND - their mother and grandmother suffered from severe mental illness. Mental illness is REAL - it's HARD - it's PAINFUL for those who suffer from it AND their loved ones as well. While NAMI does a tremendous job advocating for mental illness...there is SO MUCH MORE that needs to be done. Let's keep talking about mental illness and not hiding it. People need to know the reality that it is.

Even when we do our best to get treatment for our loved ones, the system is very often unable to deliver. And leaving it up to someone who is psychotic to decide weather or not they need treatment is a core problem. Its not like having someone in their right mind, for example, someone with heart disease decide if they want treatment. There needs to be legislative action taken in which the team of professionals along with the family decide what's the best course to follow.

My late sister's only hopes for help were sometimes the police, who had no clue. They had the gall to tell me how they laughed about her antics. The system is truly broken in so many ways and on so many levels. How many doctors or caseworkers I argued with! My sister, who happened to be brilliant (a common trait among the mentally ILL), had them convinced she was well and I was the vengeful sister of her delusions. There was also the problem of a lack of adequate insurance coverage because my sister couldn’t hold a job and was too proud to go on disability. And so they released her - too early - time and time again. Each time the episodes further damaged her thinking and our relationship. I learned way too late about advance directives. I agree that NAMI has a responsibility to take every opportunity to educate and advocate. I support NAMI, but want more ACTION to change the way our beloved mentally ILL are handled in emergency rooms, in society, in police stations, on the streets, and in their own families! They can start by publishing braver articles. It also would have been nice if they could have guided me better when I needed to find places for my sister to live in the 70s, 80s, and 90s. She ended up in worse and worse conditions until she was found dead in a tiny dirty attic apartment in a seedy neighborhood with no food and no friends. Where are our donations to NAMI being used?

Life is full of temptation to jump to the easy answer that turns out to be wrong. It seems easy to assume that somebody who kills people must have something wrong with their mind, and all we have to do is watch out for people like that and we will be safe; it would be nice if it could be that easy, but as NAMI points out, it doesn't work. IMHO, a lot of the agitation for tighter controls on people who may have mental problems is just an excuse for more gun control laws; some people never met a gun control law they didn't like, or a gun owner that they did like, and any excuse is good enough for them. The truth is that crime rates decrease, not increase, when states pass laws to let us have guns for self-defense, and multiple murders like the recent incident decrease more than just ordinary crimes. People who are still trying to sell gun control as crime control can’t win with the truth; the truth is their enemy, so we should not be surprised at the strange things they say.

I feel the government should research the criminal and mental health history of any and all individuals who apply to purchase a gun. I am the guardian of 2 children with mulitple brain disorders (mental illnesses. It truly concerns me that although my son who can appear to me mild mannered and "difficult" has the ability to purchase a gun. This teenager who will be of age to purchase a gun in 2 years may appear to be just "a little slow", can turn and become the most violent, ill-tempered and aggressive person. No criminal background but mental health history since the age of 6 should NEVER own a gun. Sad thing is when he is an adult, I not longer have control over this matter. I am not saying all "mental illnesses" fall under this category,nor am I saying all people with mental illness history will misuse a gun. In Texas they ask you about your mental health during the process of getting your driver's lisence.......but not a gun?? Somehow that just doesn't seem right!

Since it appears that James Holmes was being treated by a psychiatrist, we cannot say that he has "untreated mental illness." I will be interested to find out how long he was being treated and with what medications. Psychiatrists these days don't talk, they prescribe. Many people claim that the legally prescribed medications exacerbate or cause thoughts of violence, paranoia, and suicide ideation Will NAMI ask those questions, because these are the questions that need to be asked.

I, too, have been frustrated by the lack of leadership by anyone on the issue of addressing mental illness before a situation escalates to the point of violence.

We contribute to the stigma by not advocating for people like the young man in Colorado. Everyone is sorry for everyone, including his parents, but not for him! From all indications he could not help himself, and apparently no one else could/did. Well, I feel for him.

I really wish NAMI would step up and be the national voice of reason and education. There is so much mis-information out there (and I don't mean the part about mental illness=violence -- that horse has been beaten enough).

I'm talking about immediately using examples as a way to educate the media and the public about the many, many variants of mental illness, brain disease, brain trauma etc. and the behavioral implications of them. Stop denying that certain behavior IS a result of mental illness, and help people understand the nuances. It's not about accusing, it's about educating.

I agree that yet again we have missed an opportunity. Stop being politically correct and start being real!

I too feel that a lot of people are trying to blame Mental Illness as the cause! I have been diagnosed with a mental illness and have never gotten violent! NO ONE IS WORTH GOING TO JAIL FOR! I am tired of the STIGMA and SHAME placed on those diagnosed with a MENTAL ILLNESS that we did NOT ask for or do anything to get!

I couldnt agree with you more. I believe it was Chris Como who pointed out that we need to stop blaming gun control laws, families and look at the mental health treatment availablity. I also agree we are very educated on what to watch for but the public is not being educated about the difficulty in get help. As a mental health professional for 30+ i have seen so much discrimmination and critizing of families of the mental health consumers. Lets please support good treatment and accessible a priority.

It will be interesting to see what happens with the prosecution of James Holmes. The acts he is accused of are horrific and the pain it has caused will be with those victims and family forever. Any productive life James seems out of reach.

I have a son with bipolar that wants so much to be normal but is left knowing he cannot. He will have to battle the disease the rest of his life. He has been through at least six episodes with a recent one we are recovering from.

He has been extremely lucky even with the financial, legal and social mess he has gone through. He still has a chance at a good life but it will not be easy.

The comments made here on this blog have helped me to understand mental illness a bit more. Yes, we have had the same problems with getting help, early release from hospitals, lack of knowledge of mental illness at the hands of the police.

I somehow hope that something good comes from the tragic events in Colorado. The person James Holmes is not the problem. The inability of our society with its ignorance of mental illness, lack of compassion, restrictive privacy laws, lack of monetary aide, is the problem.

I am the mother of a son who has Schizophrenia. I believe the Colorado tragedy is not a political issue or a gun control issue. The tru issue here is the lack of proper care, treatment and funds for research for those afflicted with this MEDICAL disorder. I say MEDICAL disorder as the brain is a vital organ in our bodies like our heart and lungs. Also there is a lack of undestanding and compassion by society who have more sympathy for wounded whales, birds and other animals. If all other serious illnesses received the same LACK OF CARE AND TREATMENT and IGNORED by society - NO ONE WOULD EVER GET BETTER. THE MENTALLY DISABLED ARE TRULY THE FORGOTTEN ONES and the families who love them are heartbroken. I've been my sons strong advocate for 37 years. I hope one day to see him happy and to have at least one of his dreams come true. He is kind,loving, giving, compliant with meds. and as many other parents, I have done all that is humanly possible to help him. We need a world focus to find a cure for this devastating illness. THE FAMILIES THAT ARE FIGHTING THIS MEDICAL BATTLE ARE FIGHTING IT ALONE.

For everyone who wants to get a punch in on NAMI, please remember that NAMI is a non-profit, family education program with volunteers who need more members to help support the good fight and bring programs to families and those with mental illness. Is everyone who bashed NAMI in their comments a member. No you say, well then I challenge you to become a member and help make the changes you are asking for. I am, and I volunteer weekly to help so please don't bash NAMI for they have done wonderful things in many peoples lives, have you?

Dear anonymous of August 1st,Regarding your statement of bashing NAMI and not being a member.I made a statement. A statement of being not impressed with the communications of NAMI.I SIGNED off as a past NAMI president, past facilitator, and family member.More specifically,I started an affiliate in rural America after taking the family to family. Kept it running before it became an affiliate and until I passed it off. 5 years.I became a facilitator in support, family to family, and basics. I managed the affiliate phone calls for 5 years, helping those through a system(s) of chaos.There is more, but there you have it.Just because an organization may be doing good, is a non profit, whatever,Does NOT mean they should not be evaluated or become complacent because they attempt to do good.Sincerely,Amy Kerrigan

GO NAMI! No one else is talking about these things and putting thoughts into action as much as NAMI does while also giving us all a place to be heard. Respect. Education. Support. Advocacy in all 50 states. Don't mourn my brethren! Oganize!

Why can't we have a mandatory mental test law for all adult citizens all over the world? This way, parents would succeed at bringing up healthy youngsters and the quality of life would improve for all of humanity.When we go for a marriage license we must undergo a blood test, OK, that's good. But why not include a mental test as well?Fulvia of Greensboro, NC

I applaud NAMI for all the work they do. If it wasn't for NAMI I would not have understood at all what was happening to my son. He was diagnosed BiPolar and ultimately took his own life. I wonder if suicide is considered a violent act? My son was very loving and mild mannered most of the time. He didn't use foul language even when they were strapping him down to pump his stomach, forcing charcoal down a tube into his stomach. I would have kicked, screamed, yelled, cussed, everything...and I'm not mentally ill (or at least nobody has said so!) Suicide is violence turned inward and ends up in a fatality. I consider that a violent act upon oneself.

I think people want someone to blame, and it is handy to blame NAMI. I think that as Americans we have an obligation to insist that people with mental illness get adequate care, and not depend on how much money the individual or their family has. NAMI does not have the funds to do everything that needs to be done, but at least there are those who are speaking up and trying. If someone says mental illness is not their problem, let them go to a movie without looking over their shoulder. People think they can fit mental illness in a small government program until one young man slips through the cracks and changes the lives of many. At this point caring properly for our mentally ill is not an option, but our country's responsibility as a whole. We need to autopsy this young man's life until we find answers and then spend as much as needed to prevent this type of future or it will happen again and again. We spend enormous amounts of money on war and presidential nominations. We have our priorities wrong! We need to take care of our children no matter what it costs or we will have our own war right here.

I feel your pain and you have my prayers, and I definitely agree with your statement.My uncle was diagnosed schizophrenia and became homeless and died alone in a gas station bathroom. I didn't know until I was an adult, but no one knew what to do with him. He was in an institution and what was left of "family" thought he was being taken care of.I commend you for your hard work to care for your son.

I believe it was the war that sent my uncle into his diagnosis as well. Your story needs to be heard. Thank you for sharing it and God be with you, your son, and your family. The military should be ashamed for what they did to him, and they also owe him a great debt. We all do.

NAMI money for one goes into what's called CIT training. This is a program to train police and other first responders about what to do in the case of a mental ill person. Very effective. We need more money for this. Each NAMI group offers valuable education on the various mental illnesses for families, they also offer support groups for both the mentally ill and separately their families. NAMI has a strong voice in Washington for advocacy. NAMI has the In Our Own Voice program where recovered mentally ill tell their stories to police , rotary clubs, faith-based orgs, doctors, health center employees in the effort to stop stigma and prove that mental illness can be beat by meds in some cases.

To TS Elya, regarding your comment about sharing housing with my loved one - first of all, she was my sister not my daughter and second, obviously you've never had any experiences with the truly mentally ILL.

I am mentally I'll, though completely healed by meds and I am very pro-medicine. It is far more common for medication to stop all thoughts of violence or suicide. I would be dead if it weren't for the meds. My problem was not a "talk" problem, it is a genetic flaw that thankfully can be corrected w meds. The problem is getting a mental ill person on the meds. We often think we are not sick! They need the meds.

NAMI has a program called In Our Own Voices that I am a part of. Recovered mentally ill people like myself go around and tell our stories to police officers, doctors, community groups, faith-based groups to reduce stigma and offer hope. People learn what medication can do for the mentally ill, often turning their lives around completely. It is a good program.

I am active in NAMI and my comments are not intended to "bash NAMI ", nor do I sense "bashing" as the intention of the many other comments. It is the imploring of the National Leadership to participate, advocate & educate in the public arena when we, as a nation, deal with tragedies like this. These are issues NAMI members face daily in caring for loved ones,meeting the challenges in obtaining care in the midst of our personal cycles of grief & loss. There appear few public voices to bring balance and provide factual information to the national dialogue. Without credible, expert input to educate the general public, how do we ever hope to turn the tide on the many fronts endured by those living with this medical-mental health issue?

To the previous Anonymous blogger who asked if those "bashing" NAMI were members. YES, I have been a member for over 30 years. I participated in the very first family education group - then called Journey of Hope and I was a facilitator of that group for a time. I was an ACTIVE member. The NAMI of today is not the NAMI that was envisioned back then. It has turned out, in too many situations, NOT to be a voice for the families of those suffering from SEVERE mental illness. It is now, under the present leadership, more concerned with being politically correct. Don't call it mental illness -- call it mental health. Don't talk about severe illnesses such as schizophrenia -- it is more acceptable to speak of depression. Don't really, really advocate for the mentally ill -- it appears they don't seem to be as deserving of hard-hitting advocacy as those suffering from cancer, diabetes, heart disease, breast cancer or downs syndrome. Stop and really look at what those advocacy movements have accomplished. If NAMI will not advocate for the people they were charged to advocate for - then who? We are at a serious crossroads with NAMI -- either get real leadership with courage or just admit to what you are. You are fooling no one. This will probably not be published but it felt good to get it out.

God bless you and your son, and thank him for his service. I hope that he can find, with your loving motherly help, the assistance he needs. I do highly recommend NAMI as an organization that has helped my family. It can support you both and provide accesss to invaluable organizations you would not have known of otherwise. Nami understands at the local level the challenges families living with mental illness face.

Not everybody with mental illness refuses to seek help, but oftentimes is discouraged due to society's view of the problem as well as the absolutely outrageous lack of assistance for the ones in need of it. Not to mention the extremely expensive treatment hey would have to undergo even wih insurance. Sometimes is easier and a lot cheaper to go untreated or self-medicate, which is what James Holmes was doing.

I love your comment and wish more people were like you. As I was watching James Holmes' face in court, I got the impression of someone who has realized something they've done wrong. I don't think he put up an act. The way he acts in jail is also consistent with somebody who feels very much lonely and singled-out, unable to reach out for help because shame and rejection are indeed painful, really painful. People with mental Illness are people too, but they are the kind of people that not only have to deal with the PHYSICAL symptoms of their illness but also the stigma society places on them causing their isolation from the world. It will never change unless we take a pro-active approach educating the general population on this issue, starting with our children in school.

Your statement is so true. You did not have the understanding and capacity to deal with it because you were not informed. However, information is voluntary and readily available to those who seek it. When somebody comes down with cancer don't you want to know what the prognosis is and make your best to ease their pain and help them as much as you can?. I would think if you cared for your loved one and know how to you would do it.

I agree and am so angry about the previous comment. if one is able to find appropriate treatment at all they and thoseof us who love them must deal with insensitive and uninformed, even uneducated, treatment facilities that are more concerned with meeting their quotas than treating the ones that so desperately need their help or supporting and educating the families or loved ones who also deal with the pain and suffering that these mental illnesses can create. Best care treatment center in redmond, or falls into this category. Help our loved ones get help